한빛사 논문
Kaichi Kaneko1, Hao Chen1,2, Matthew Kaufman1,3, Isaak Sverdlov1,4, Emily M. Stein5,6, Kyung-Hyun Park-Min1,7,8,*
1Arthritis and Tissue Degeneration Program, David Z. Rosensweig Genomics Research Center, Hospital for Special Surgery, New York, New York 10021, USA
2Department of Orthopedics, Beijing Friendship Hospital, Beijing 100050, China
3Case Western Reserve School of Medicine, Cleveland, Ohio 44106, USA
4Tuoro College of Osteopathic Medicine-New York Campus, New York, New York 10027, USA
5Endocrinology Service, Hospital for Special Surgery, New York, New York, USA
6Metabolic Bone Disease Service, Hospital for Special Surgery, New York, New York, USA
7Department of Medicine, Weill Cornell Medical College, New York, New York, USA
8BCMB allied program, Weill Cornell Graduate School of Medical Sciences, New York, New York 10021, USA
*Correspondence : Kyung-Hyun Park-Min, Ph.D. Arthritisand Tissue Degeneration Program, DavidZ. Rosensweig Genomics Research Center, Hospital for Special Surgery, NewYork, NY 10021, USA.
Abstract
Osteonecrosis (ON) is a complex and multifactorial complication of systemic lupus erythematosus (SLE). ON is a devastating condition that causes severe pain and compromises the quality of life. The prevalence of ON in SLE patients is variable, ranging from 1.7% to 52%. However, the pathophysiology and risk factors for ON in patients with SLE have not yet been fully determined. Several mechanisms for SLE patients’ propensity to develop ON have been proposed. Glucocorticoid is a widely used therapeutic option for SLE patients and high-dose glucocorticoid therapy in SLE patients is strongly associated with the development of ON. Although the hips and knees are the most commonly affected areas, it may be present at multiple anatomical locations. Clinically, ON often remains undetected until patients feel discomfort and pain at specific sites at which point the process of bone death is already advanced. However, strategies for prevention and options for treatment are limited. Here, we review the epidemiology, risk factors, diagnosis, and treatment options for glucocorticoid-induced ON, with a specific focus on patients with SLE.
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